Jessica Marie Mitchell, CRNP, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-127148 Issued in AL

Practice address

488 Saint Lukes Dr
Montgomery, AL 36117-7104

Phone

(334) 288-7808

Fax

(334) 288-8089

NPI assigned

Jul 17, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jessica.mitchell.1@11679.direct.athenahealth.com
• Direct secure messaging: jessica.mitchell@direct.baptistfirst.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1700293149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177104",
            "telephone_number": "334-288-7808",
            "fax_number": "334-288-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177104",
            "telephone_number": "334-288-7808",
            "fax_number": "334-288-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-127148",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-127148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Square Chiropractic Clinic
• Brandon H Mitchell, MD
• Bryant Mitchell
• Elizabeth Mitchell, LPC
• Eric Mitchell, PT, DPT
• Mildres Arlette Mitchell
• Paris Mitchell
• Rachel Mitchell
• Regina Mitchell, L.P.N
• Savannah Mitchell

• Nurse Practitioner in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.